Tuesday, October 5, 2021

Case Reports in Otolaryngology

Frontal Sinus "Hump": An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out), Teppei Takeda, Kazuhiro Omura, Haw Torng, Teru Ebihara, Satoshi Aoki, Kosuke Tochigi, Hiromi Kojima, and Nobuyoshi Otori
Volume 2021 (2021), Article ID 3402496, 5 pages
Unilateral Cysticercosis of the Parotid Gland: Case Report, Diagnosis, and Clinical Management, Zachary Elwell, Shethal Bearelly, Khalid Aboul-Nasr, and Jonathan Lara
Volume 2021 (2021), Article ID 9999441, 4 pages
Traumatic Cochlear Implant Electrode Extrusion: Considerations, Management, and Outcome, Ching Yee Chan, Feifan Wang, Haryani Omar, and Henry Kun Kiaang Tan
Volume 2021 (2021), Article ID 2918859, 4 pages
The Rare Cases of Parotid Gland Arteriovenous Malformations, Manish Gupta, Vijay Shrawan Nijhawan, Cynthia Kaur, Sukhpreet Kaur, and Akanksha Gupta
Volume 2021 (2021), Article ID 6072155, 5 pages
Osteochondroma Arising from the Thyroid Cartilage: A Case Report and Literature Review, Jessa E. Miller, Shaghauyegh S. Azar, and Dinesh K. Chhetri
Volume 2021 (2021), Article ID 8286012, 4 pages
A Rare Case of Posttraumatic Bilateral BPPV Presentation, Sinisa Maslovara, Andro Kosec, Ivana Pajic Matic, and Anamarija Sestak
Volume 2021 (2021), Article ID 8636676, 5 pages
Nasopharyngeal Coil Dislocation of an Embolized Internal Carotid Artery Pseudoaneurysm, Nazli Ay, Ingo Todt, and Holger Sudhoff
Volume 2021 (2021), Article ID 4270441, 4 pages
Presence of Two Separate Hairy Polyps with Meningothelial Elements in a 15-Month-Old Child, Ahmad Saeed A. Alghamdi, Nasser Almutairi, and Ghassan Alokby
Volume 2021 (2021), Article ID 1844244, 5 pages
Case of Amelanotic Malignant Melanoma of the Lingual Base That Was Diagnosed Based on a Biopsy of Late Metastasis to a Lumbar Vertebra after Being Misdiagnosed as HPV-Positive Oropharyngeal Anterior Wall Squamous Cell Carcinoma, Takumi Okuda, Shinsuke Ide, Kei Kajihara, and Tetsuya Tono
Volume 2021 (2021), Article ID 7139280, 6 pages
Survival of Toddler with Aortoesophageal Fistula after Button Battery Ingestion, Hannah Gibbs, Rishabh Sethia, Patrick I. McConnell, Jennifer H. Aldrink, Toshiharu Shinoka, Kent Williams, and Kris R. Jatana
Volume 2021 (2021), Article ID 5557054, 7 pages

#
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Telephone consultation 11855 int 1193,

Reflection-Source Emissions Evoked with Clicks and Frequency Sweeps: Comparisons Across Levels

xlomafota13 shared this article with you from Inoreader

Abstract

According to coherent reflection theory, otoacoustic emissions (OAE) evoked with clicks (clicked-evoked, CE) or tones (stimulus frequency, SF) originate via the same mechanism. We test this hypothesis in gerbils by investigating the similarity of CE- and SFOAEs across a wide range of stimulus levels. The results show that OAE transfer functions measured in response to clicks and sweeps have nearly equivalent time–frequency characteristics, particularly at low stimulus levels. At high stimulus levels, the two OAE types are more dissimilar, reflecting the different dynamic properties of the evoking stimulus. At mid to high stimulus levels, time–frequency analysis reveals contributions from at least two OAE source components of varying latencies. Interference between these components explains the emergence of strong spectral microstructure. Time–frequency filtering based on mean basilar-membrane (BM) group delays (τBM) shows that late-late ncy OAE components (latency ~ 1.6τBM) dominate at low stimulus intensities and exhibit highly compressive growth with increasing stimulus intensity. In contrast, early-latency OAE components (~ 0.7τBM) are small at low stimulus levels but can come to dominate the overall response at higher intensities. Although the properties of long-latency OAEs are consistent with an origin via coherent reflection near the peak of the traveling wave, the generation place and/or mechanisms responsible for the early-latency OAE components warrant further investigation. Because their delay remains in constant proportion to τBM across sound intensity, long-latency OAEs, whether evoked with tones or clicks, can be used to predict characteristics of cochlear processing, such as the sharpness of frequency tuning, even at high stimulus levels.

View on the web

Necessity of Intraoperative Level IIA Lymph Node Dissection in Patients with Carotid Body Tumors: A Retrospective Study of 126 Cases

xlomafota13 shared this article with you from Inoreader

1367324

Background: Carotid body tumors (CBTs) are relatively uncommon neoplasms that rarely have malignant potential. However, malignant CBTs (MCBTs) are still associated with a poor prognosis and the treatment is still challenging clinically. Therefore, we evaluated the necessity of intraoperative level IIA lymph node dissection in patients with CBT. Methods: The clinical characteristics, intraoperative details, and pathological diagnosis of 126 CBT patients who had undergone surgery were retrospectively reviewed. The patients were divided into 2 groups according to whether level IIA lymph node dissection was performed. The prognosis was analyzed using Kaplan-Meier curves and Cox model multivariate survival analysis. Results: Among the 126 patients, 7 patients (10.3%) in the selective lymph node dissection (SLND) group (68 patients) were diagnosed with MCBTs with evidence of lymph node metastasis. Two patients (3.4%) in the lymph node nondissection (LNND) group (58 patients) were diagnosed with MCBTs later after the second operation because they could not be diagnosed as malignant initially because of the lack of lymph node pathology results although the pathology of the primary lesion showed features of malignancy. The SLND group had a significantly higher relapse-free survival rate than the LNND group (94.1% vs. 79.3%, p = 0.021). Patients with a confirmed diagnosis had a better prognosis than those with insufficient evidence of a malignancy due to the lack of lymph node information. Twenty-nin e patients in the SLND group and 26 patients in the LNND group had postoperative nerve injuries, with no significant difference between the groups (p = 0.879). Conclusion: Intraoperative dissection of level IIA lymph nodes around the tumor in CBT patients can help improve the diagnosis and prognosis of MCBTs without causing additional cranial nerve injury.
ORL
View on the web

TRPV1 mediates itch‐associated scratching and skin barrier dysfunction in DNFB‐induced atopic dermatitis mice

xlomafota13 shared this article with you from Inoreader

Abstract

In chronic pruritic diseases such as atopic dermatitis (AD), pruritus and skin lesions is exacerbated by scratching in clinical and experimental settings. TRPV1 is known to mediate itch and neurogenic inflammation, but the role of TRPV1 in itch-associated scratching in AD is poorly understood. In this study, we examined the efficacy of cutting off nails and TRPV1 antagonist, ruthenium red (RR) in a murine model of AD induced by DNFB and further investigated the underlying mechanism. Nail clipping or RR could markedly ameliorate the general AD-like symptoms as manifested by the reduced clinical severity of dermatitis, IgE and Th2-related cytokine levels, and mast cell degranulation. Moreover, scratching behavior, the levels of pruritogenic mediators, including HIS, TSLP, IL-31 and SP, and skin pH and TEWL were all significantly decreased in nail clipping or RR-treated mice, suggesting a reduction in itch-associated scratching and skin barrier defects. Immunofluorescence staini ng and western blot results revealed that that antipruritic effect of nail clipping or RR in AD may be explained, at least in part, by the suppression of TRPV1 activation. In summary, these data show that TRPV1 mediates itch-associated scratching and subsequent skin barrier defects, suggesting its potential as a therapeutic target in AD.

View on the web

Acute Paediatric Mastoiditis

xlomafota13 shared this article with you from Inoreader

Abstract

Objectives

To explore the impact of COVID-19 on the management and outcomes of acute paediatric mastoiditis across the UK.

Design

National retrospective and prospective audit

Setting

48 UK secondary care ENT departments

Participants

Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis.

Main outcome measures

Cases were divided into: Period 1 (01/11/19-15/03/20) before the UK population were instructed to reduce social contact, and Period 2 (16/03/20-30/04/21), following this. Periods 1&2 were compared for population variables, management and outcomes. Secondary analyses compared outcomes by primary treatment (medical/needle aspiration/surgical).

Results

286 cases met criteria (median 4 per site, range 0-24). 9.4 cases were recorded per week in period 1 versus 2.0 in period 2, with no winter increase in cases in Dec 2020-Feb 2021. Patient age differed between period 1&2 (3.2 Vs 4.7 years respectively, p<0.001). 85% of children in period 2 were tested for COVID-19 with a single positive test. In period 2 cases associated with P. aeruginosa significantly increased. 48.6% of children were scanned in period 1 vs 41.1% in period 2. Surgical management was used more frequently in period 1 (43.0% Vs 24.3%, p=0.001).

Treatment success was high, with failure of initial management in 6.3%, and 30-day re-admission for recurrence in 2.1%. The adverse event rate (15.7% overall) did not vary by treatment modality or between periods 1& 2.

Conclusion

The COVID-19 pandemic led to a significant change in the presentation and case-mix of acute paediatric mastoiditis in the UK.

View on the web

Indocyanine green angiography in breast reconstruction surgery: A systematic review of cost-analysis studies

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2021 Sep 14:S1748-6815(21)00400-9. doi: 10.1016/j.bjps.2021.08.013. Online ahead of print.

NO ABSTRACT

PMID:34607780 | DOI:10.1016/j.bjps.2021.08.013

View on the web

A systematic review and meta-analysis of urethral complications and outcomes in transgender men

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2021 Sep 4:S1748-6815(21)00384-3. doi: 10.1016/j.bjps.2021.08.006. Online ahead of print.

ABSTRACT

BACKGROUND: Urologic problems, such as urethral fistulas and strictures, are among the most frequent complications occurring after phalloplasty. Although many studies have reported successful phalloplasty and urethral reconstruction with reliable outcomes in transgender men, no method has become standardized so far. This study aimed to summarize the results of reports on urological complications and outcomes in transgender men with respect to various types of urethral reconstruction.

METHODS: A comprehensive literature search of PubMed, Scopus, and Google Scholar databases was conducted for studies related to phalloplasty in transsexuals. Data on various phallic urethral techniques, urethral complications, and outcomes were collected and analyzed using the random-effects model.

RESULTS: A total o f 21 studies (1,566 patients) were included: eight studies (1,061 patients) on "tube-in-tube," nine studies (273 patients) on "prelaminated flap," and six studies (221 patients) on "second flap." Compared with the tube-in-tube technique, the prelaminated flap was associated with a significantly higher urethral stricture/stenosis rate; however, there was no difference between the prelaminated flap and the second flap techniques. For all phalloplasty patients, the pool rate of urethral fistula or stenosis is 48.9%, the rate of the ability to void while standing is 91.5%, occurrence rate of tactile or erogenous sensation is 88%, the prosthesis complication rate is 27.9%, and patient-reported satisfactory outcome rate is 90.5%.

CONCLUSION: Urethral reconstruction with a prelaminated flap was associated with a significantly higher urethral stricture rate and increased need of revision surgery compared with that observed using a skin flap. Overall, most patients were able to void wh ile standing and were satisfied with the outcomes.

PMID:34607781 | DOI:10.1016/j.bjps.2021.08.006

View on the web

A Tertiary Care Centre Experience on the Management of Paediatric Tracheobronchial Foreign Body During the COVID 19 Pandemic

xlomafota13 shared this article with you from Inoreader

Abstract

Tracheobronchial foreign body aspiration (FBA) is a life threatening emergency most commonly seen among paediatric age group that requires immediate therapeutic intervention. The purpose of this study is to report our experience on management of these aspirated foreign body (FB) with rigid bronchoscopy during the COVID 19 pandemic. This is a retrospective study which included 100 children less than 17 years of age, diagnosed with suspected FBA and underwent rigid bronchoscopy for its removal between March 2020 and March 2021. Guardians of all female children with history of FBA, had to go through medicolegal enquiry considering the possibility of female infanticide. Analysis of data was made of the demographic details, characteristics and location of the aspirated FB, treatment modalities and difficulties encountered. Among the 100 patients included in the study, 67% were under 3 years of age. The male to female ratio was 2.23:1. 69% of the FB's were most frequently found in the right main bronchus. 63 cases of the removed FB were organic materials such as nuts. Tracheobronchial FB's should be suspected in children who have sudden onset of cough and respiratory distress, even when physical and radiographic evidence is absent. Mortality due to FBA is preventable by early intervention with bronchoscopy. During the Covid 19 pandemic before performing any emergency procedure, prior preoperative planning and use of personal protective equipment is important, considering the very high risk of transmission of the virus due to aerosol generation.

View on the web

Transcanal endoscopic management of lateral semicircular canal fistula: preliminary experience

xlomafota13 shared this article with you from Inoreader

Eur Arch Otorhinolaryngol. 2021 Oct 5. doi: 10.1007/s00405-021-07095-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Labyrinthine fistula is one of the most frequent complications of cholesteatoma (CHO), occurring in about 8% of cases in the literature. In about 90% of cases, it is located at the level of the lateral semicircular canal, and its clinical manifestation includes vertigo, nystagmus and positive Hennebert and Tullio signs. The management of lateral semicircular canal fistula (LSCF) secondary to CHO classically requires a retroauricular access by performing a canal wall-up (CWU) or canal wall-down (CWD) mastoidectomy. However, in case of a CHO confined to the tympanic cavity causing a LSCF on the ampullar arm, a transcanal exclusive endoscopic approach could be considered.

AIMS: The aim of this study is to describe the feasibility of a transcanal exclusive endoscopic approach in the management of a CHO confined to the tympanic cavity causing a LSCF on the ampullar arm.

METHODS: From January 2019 to December 2020, three patients with LSCF secondary to mesotympanic CHO underwent transcanal exclusive endoscopic ear surgery repair at the Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Italy.

RESULTS: This technique was successfully employed to treat LSCF in all three cases and was planned as a two-stage surgery, performing ossiculoplasty after 12-18 months. Functional outcomes were also satisfactory: complete eradication of CHO, hearing preservation and complete resolution of symptoms.

CONCLUSIONS: In case of a CHO confined to the tympanic cavity causing an LSCF on the ampullar arm, a transcanal exclusive endoscopic approach could be considered as a feasible and safe technique.

PMID:34609605 | DOI:10.1007/s00405-021-07095-8

View on the web

KTP laser endoscopic cricopharyngeal myotomy and pharyngeal pouch diverticulotomy: how I do it

xlomafota13 shared this article with you from Inoreader

Eur Arch Otorhinolaryngol. 2021 Oct 5. doi: 10.1007/s00405-021-07101-z. Online ahead of print.

ABSTRACT

BACKGROUND: Various endoscopic methods of dividing the cricopharyngeus muscle and the common wall of pharyngeal pouches have been described, most commonly the carbon dioxide laser and stapler. The potassium titanyl phosphate (KTP) laser is an alternate endoscopic method of treatment.

METHODS: The KTP laser is used in a similar fashion to the carbon dioxide laser to carefully divide the cricopharyngeus muscle fibres ± the common wall of the pharyngeal pouch, under microscopic visualization.

CONCLUSION: The KTP laser is an alternative and safe technique for these surgeries.

PMID:34609606 | DOI:10.1007/s00405-021-07101-z

View on the web

Collaboration request

Hi there How would you like to earn a 35% commission for each sale for life by selling SEO services Every website owner requires the ...